PD36-05 PELVIC FLOOR MUSCLE EXERCISE-BASED BEHAVIORAL THERAPY IMPROVES URINARY SYMPTOMS IN PARKINSON DISEASE

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction II1 Apr 2018PD36-05 PELVIC FLOOR MUSCLE EXERCISE-BASED BEHAVIORAL THERAPY IMPROVES URINARY SYMPTOMS IN PARKINSON DISEASE Camille Vaughan, Kathryn Burgio, Patricia Goode, Jorge Juncos, Lisa Muirhead, Gerald McGwin, and Theodore Johnson Camille VaughanCamille Vaughan More articles by this author , Kathryn BurgioKathryn Burgio More articles by this author , Patricia GoodePatricia Goode More articles by this author , Jorge JuncosJorge Juncos More articles by this author , Lisa MuirheadLisa Muirhead More articles by this author , Gerald McGwinGerald McGwin More articles by this author , and Theodore JohnsonTheodore Johnson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1728AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary symptoms of overactive bladder (OAB), including urgency, frequency, nocturia, and urgency urinary incontinence are common in Parkinson disease (PD) and further worsen quality of life. Pelvic floor muscle exercise-based behavioral therapy is side effect free and effective for OAB symptoms in adults without PD. We sought to determine the efficacy of behavioral therapy for OAB symptoms in PD. METHODS We conducted a randomized controlled trial of behavioral therapy compared to a control condition at two VA medical centers. Participants were diagnosed with PD by a movement disorders neurologist and had ≥ 4 episodes of urinary incontinence/week. Behavioral therapy included pelvic floor muscle exercises with urge suppression training, fluid modification, constipation management, and self-monitoring with a bladder diary. The control condition included a bladder diary and mirrored shape drawing. Outcomes were measured eight weeks post-randomization and included the International Consultation on Incontinence OAB symptom score (range 0-16) as well as bother and quality of life questionnaires (higher scores=worse outcomes) and bladder diary-based weekly urinary incontinence. Outcomes were evaluated using intention-to-treat analysis with generalized linear models adjusted for baseline symptoms and last observation carried forward for missing outcome data (11%). RESULTS 53 participants were randomized and 47 reported 8-week outcome data including 26 randomized to behavioral therapy and 21 to control (6 dropouts in control). Behavioral vs. control participants were similar with respect to age (71.0 ± 6.1 vs. 69.7 ± 8.2 years), gender (70% vs. 78% male), PD motor severity score, cognition, mean weekly urinary incontinence episodes (13.6 ± 9.8 vs. 15.2 ± 11.1) and OAB symptoms (8.9 ± 2.4 vs. 8.3 ± 2.2). Behavioral therapy participants reported greater reduction in OAB symptoms compared to control ((-3.1 ± 2.8) vs. (-1.3 ± 2.1), p=0.02). Weekly urinary incontinence reduction was similar between behavioral (-5.3 ± 8.7) and control participants (-4.9 ± 11.5) (p=0.4). After 8 weeks, quality of life and bother related to OAB were significantly improved among participants in behavioral therapy compared to control (p=0.001 and p=0.03). CONCLUSIONS Behavioral therapy resulted in significantly greater improvement in OAB symptoms, bother, and quality of life compared with control. Weekly incontinence episodes improved in both groups, but without between-group differences. Providers should consider behavioral therapy as initial therapy for OAB symptoms in PD. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e728 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Camille Vaughan More articles by this author Kathryn Burgio More articles by this author Patricia Goode More articles by this author Jorge Juncos More articles by this author Lisa Muirhead More articles by this author Gerald McGwin More articles by this author Theodore Johnson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...